An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored. A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure. Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Since the emergence of the science of international relations as an independent academic scientific field, various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories, which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination
... Show MoreThe duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.
The extract of fig fruit has shown significant medical usefulness in various fields. The entrance of nanotechnology into the field of medicinal and pharmacology has shown remarkable advantages. Plants contain diverse molecules thatcan reduce metals, and provide a safe, eco-friendly approach for synthesizing nanoparticles. Iron oxide nanoparticles (IONPs) have been reported to possess an antimicrobial effect against some strains of bacteria and moulds. We have aimed to synthesize IONPs from fig fruit extract and investigate the influence of fig extract and IONPs in wound healing of mice. UV-Vis spectroscopy, X-ray diffraction (XRD), and field emission scanning electron microscopy were used to characterize the IONPs that were produced
... Show MoreLying is a controversial issue as it is closely related to one's intended meaning to achieve certain pragmatic functions. The use of lying in literary works is closely related to the characters’ pragmatic functions as in the case of Miller's The Crucible where it is used as a deceptive complex phenomenon that cannot be observed out of context. That is, the use of lying as a deceptive phenomenon represents a violation to Grices's Maxims. Thus, the study aims to qualitatively examine the kinds of maxims being violated, the kinds of violations conducted, the strategies followed in the violations, and the pragmatic functions behind such violations across the different categories of lies. To this end, the (30) extracts fou
... Show MoreThis abstract focuses on the significance of wireless body area networks (WBANs) as a cutting-edge and self-governing technology, which has garnered substantial attention from researchers. The central challenge faced by WBANs revolves around upholding quality of service (QoS) within rapidly evolving sectors like healthcare. The intricate task of managing diverse traffic types with limited resources further compounds this challenge. Particularly in medical WBANs, the prioritization of vital data is crucial to ensure prompt delivery of critical information. Given the stringent requirements of these systems, any data loss or delays are untenable, necessitating the implementation of intelligent algorithms. These algorithms play a pivota
... Show MoreYouTube is not just a platform that individuals share, upload, comment on videos; teachers and educators can utilize it to the best maximum so that students can have benefits. This study aims at investigating how active and influential YouTube can be in the educational process and how it is beneficial for language teachers to enhance the skills of students. The study demonstrates different theoretical frameworks that tackle the employment of technology to enhance the learning/teaching process. It relies on the strategies of Berk (2009) for using multimedia media, video clips in particular to develop the abilities of teachers for using technology in classrooms. To achieve the objective of the study, the researchers develop a questionnair
... Show MoreIn every country in the world, there are a number of amputees who have been exposed to some accidents that led to the loss of their upper limbs. The aim of this study is to suggest a system for real-time classification of five classes of shoulder girdle motions for high-level upper limb amputees using a pattern recognition system. In the suggested system, the wavelet transform was utilized for feature extraction, and the extreme learning machine was used as a classifier. The system was tested on four intact-limbed subjects and one amputee, with eight channels involving five electromyography channels and three-axis accelerometer sensor. The study shows that the suggested pattern recognition system has the ability to classify the sho
... Show MoreThis research deals with the nature of the Turkish attitude towards the events of the Arab Spring which the Arab region witnessed recently, as this attitude is characterized by hesitation and utter confusion about those events at its beginning. However, the development of events and the consequent repercussions led the Turkish decision makers of the foreign policy to reconsider their attitude towards those events for political, economic, cultural and social motives.